title: Decline in residual renal function in automated compared with continuous ambulatory peritoneal dialysis.
abstract: OBJECTIVE
  We compared the decline of RRF in patients starting dialysis on APD with those starting on CAPD, because a faster decline on APD has been suggested.
  
  
  METHODS
  NECOSAD patients starting dialysis on APD or CAPD with RRF at baseline were included and followed for 3 years. Residual GFR (rGFR) was the mean of urea and creatinine clearances. Differences in yearly decline of rGFR were estimated in analyses with linear repeated measures models, whereas the risk of complete loss of RRF was estimated by calculating hazard ratios (HRs) for APD compared with CAPD. As-treated (AT) and intention-to-treat (ITT) designs were used. All of the analyses were adjusted for age, gender, comorbidity, and primary kidney disease and stratified according to follow-up and mean baseline GFR.
  
  
  RESULTS
  The 505 CAPD and 78 APD patients had no major baseline differences. No differences were found in the analyses on yearly decline of rGFR. APD patients did have a higher risk of losing RRF in the first year (ITT crude HR 2.43 [confidence interval 95%, 1.48 to 4.00], adjusted 2.66 [1.60 to 4.44]; AT crude 1.89 [1.04 to 3.45], adjusted 2.15 [1.16 to 3.98]). The higher risk of losing all RRF was most pronounced in patients with the highest rGFR at baseline (ITT; crude 3.91 [1.54 to 9.94], adjusted 1.85 to 14.17).
  
  
  CONCLUSIONS
  The risk of losing RRF is higher for patients starting dialysis on APD compared with those starting on CAPD, especially in the first year.
authors.affiliation: Division of Nephrology, Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. w.m.michels@amc.uva.nl
authors.forename: Wieneke Marleen
authors.initials: WM
authors.lastname: Michels
authors.forename: Marion
authors.initials: M
authors.lastname: Verduijn
authors.forename: Diana C
authors.initials: DC
authors.lastname: Grootendorst
authors.forename: Saskia
authors.initials: S
authors.lastname: le Cessie
authors.forename: Elisabeth Wilhelmina
authors.initials: EW
authors.lastname: Boeschoten
authors.forename: Friedo Wilhelm
authors.initials: FW
authors.lastname: Dekker
authors.forename: Raymond Theodorus
authors.initials: RT
authors.lastname: Krediet
mesh_terms: D000328:Adult; D000368:Aged; D001331:Automation; D016009:Chi-Square Distribution; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome